• do diseases exist independently of social and historical
o yes because there is a biological existence
o there are biological processes at stake, but they way
these biological processes are presented and
interpreted there is some type of play that pushes
symptoms to one side or the other.
How Do Cultures Shape the Illness Experience?
• Every culture has a melancholic experience, but not every
culture experiences sadness/melancholia in the same way
western society does. Western society recognizes this as
disease, known as ‘depression’. A mental state related to a
loss of connectedness.
• Every culture has unique expressions of these states of being.
o a Nigerian man might experience sadness and then
explain his symptom has a ‘peppery feeling in the head’
o Chinese farmer might describe it has stomach pain
o Indian man might describe it as a loss in semen or a
o Native American – something akin to loneliness
• There is a universalism with the experience of
depression/sadness but the way they are localized in the body
and the way they’re expressed are totally dependent on the
culture and society they are embedded in.
• There is a reality to the conditions but the way they manifest
themselves are open to a kind of manipulation of culture. A
culture can shape they way we describe the symptoms we’re
experiencing. What symptoms are ok to describe? It is
• Cultures also often differ in explanatory models.
o There are legitimate and illegitimate ways to present
symptoms in every culture.
o These are culturally defined
• the interplay between the expectations of the culture and the
experience of the individual leads to a cycle of symptom
• beliefs about the cause symptomology and the course of an
illness such as depression tend to be self fulfilling
• when applying the DSM and other diagnosing manuals to
different cultures, it might not apply or work properly • a lot of cultures understand diseases as a manifestation of a
social circumstance within the body
• not every culture agrees that sadness is a bad thing or a
• not all cultures will want to speak of their social and
emotional symptoms to strangers (doctors & professionals)
they speak about it with their close family and friends and
• speaking with a doctor is a cultural thing here in the West
• cultural conceptions surrounding illnesses can be influenced
and shifted overtime
• the clinical presentation of depression and anxiety is a
function not only of patients ethnocultural backgrounds, but
of the structure of the health care system they find
themselves in and the diagnostic categories and concepts
they encounter in mass media and in dialogue with family,